Situational analysis of practice patterns and challenges in cardiovascular disease management: A qualitative study

Background: Optimal management of cardiovascular diseases (CVDs) in developing countries is hindered by challenges among patients, caregivers, and health-care providers, understanding which is critical for CVD control. Objective: To explore the perspectives of patients with CVD, their caregivers, and health-care providers on the burden of the disease and challenges in management and to evolve strategies for improvement of care. Methods: A qualitative study using focus group discussions (FGDs) with patients and caregivers and in-depth interviews (IDIs) with care providers was conducted. Thematic analysis of data from FGDs and IDIs was done by inductive examination of textual information. Key subthemes and themes that emerged were recorded. Results: A total of 12 FGDs and 13 IDIs were conducted. Participants perceived CVDs as a big problem in both urban and rural areas. Lack of resources and time, lengthy and tedious procedures, high patient load, lack of awareness about standard treatment guidelines among private practitioners, and inadequate involvement of family members emerged as the key challenges in the control of CVDs. Training of private practitioners, nurse educators, and doctors in the public health system; strengthening of the existing national program; and greater involvement of family members in care of patients were the key strategic suggestions for improvement of care in CVD. Conclusion: Control of CVDs is laced with many challenges which involve multiple stakeholders. Addressing this issue demands a multipronged approach with interventions directed at empowering the patient and the caregivers and enhancing their involvement in care along with strengthening the health system.